Your Right to Know

WASHINGTON — With just hours to spare, Congress moved yesterday to finish legislation to prevent
doctors who treat Medicare patients from being hit with a 24 percent cut in their payments from the
government.

The Senate’s 64-35 vote sends a measure to delay the cuts for a year to President Barack Obama,
who’s expected to quickly sign it. The House passed the measure last week.

The $21 billion measure would stave off a 24 percent cut in Medicare reimbursements to doctors
for a year and extend dozens of other expiring health-care provisions such as higher payment rates
for rural hospitals. The legislation is paid for by cuts to health-care providers, but fully half
of the cuts won’t kick in for 10 years.

It’s the 17th temporary “patch” to a broken payment formula that dates to 1997 and comes after
lawmakers failed to reach a deal on financing a permanent fix.

The measure passed the House on Thursday, but only after top leaders in both parties engineered
a voice vote when it became clear they were having difficulty mustering the two-thirds vote
required to advance it under expedited procedures. Several top Democrats opposed the bill, saying
it would take momentum away from the drive to permanently solve the payment-formula problem.

There’s widespread agreement on bipartisan legislation to redesign the payment formula. But
there’s no agreement on how to pay the approximately $140 billion cost of scrapping the old
formula.

Senate Finance Committee Chairman Ron Wyden, D-Ore., promised to keep pressing ahead with a
long-term solution, proposing to use savings from the troop drawdown in Afghanistan to pay the
cost. Republicans and most budget experts say such savings are phony and are demanding that at
least some of the money come from cuts to Obama’s Affordable Care Act.

“Paying for this through (war savings) is the mother of all gimmicks,” said Sen. Jeff Sessions,
R-Ala.

“We just don’t have the votes right now to fix this problem for good,” said Majority Leader
Harry Reid, D-Nev., who negotiated the measure with House Speaker John Boehner, R-Ohio. “For the
millions of elderly Americans and their doctors, this fix is good news. It means the promise of
accessible, quality health care to our nation’s seniors is being honored for another year.”

The measure would give Medicare doctors a 0.5 percent fee increase through the end of the year.
It also would create two new mental-health grant programs, including $1.1 billion over four years
for improvements to community health centers and $60 million over four years for outpatient
treatment of people with serious mental illness.